Ketoconazole Shampoo: What, Why, and How Does It Work?

Updated on March 15, 2019

Ketoconazole shampoo is a medicated shampoo aimed at treating scalp conditions. Depending on the concentration of the active ingredient, itmay be available over-the-counter. For more concentrated versions, you’ll need a script from the doctor. 

Ketoconazole shampoo contains a potent antifungal agent that helps to combat fungus. For those with dandruff, it should reduce the itching, scaling, and flaking that accompanies the condition.  

What is Ketoconazole Shampoo Used For?

This DHT blocking shampoo is used to fight dandruff, Psoriasis, and Tinea infections. Some users swear by it to reduce or reverse hair loss. It is unclear whether hair loss reversal has been scientifically proven, but the shampoo could help with alopecia which is caused by conditions that affect the scalp. 

Ketoconazole shampoo, with a 2% concentration, is used to treat the darkening or lightening of the skin caused by Tinea Versicolor.  

How to Use Ketoconazole Shampoo

Only use this shampoo as directed by a health care professional, or by the instructions on the bottle, if different from those listed below.

Start by wetting your scalp and hair with clean water. Lather the shampoo in your hand so that you have enough to cover the scalp and clean the hair. You don’t need a lot; if it’s not lathering, try adding more water.  

Massage it into the scalp, leaving it in for five minutes before rinsing with warm, clean water. If you have an over-the-counter version of Ketoconazole shampoo, repeat. If you have a stronger concentration, follow the instructions provided by your health care professional.  

If you’re not using it on your scalp, wet the area that it is to be applied to. Then lather up the shampoo and cover a little more than just the area of infection. Leave it in place for five minutes and then rinse it off with warm, clear water. 

It’s not advisable to use this product on irritated or broken skin. Also, be careful not to get it into your eyes. If any does get into your eyes, rinse them thoroughly with clean water.  

You should see a definite improvement after two weeks of use. It may take up to four weeks to clear up the condition. If it still has not cleared up after this time, or if it seems to be getting worse, consult your doctor.

Ketoconazole Shampoo Side Effects

Most people find that the side effects are minimal. They usually go away after you’ve been using the product for a certain period. The side effects might include:

  • Discoloration of the skin
  • Irritation or a mild rash
  • Small bumps that look like pimples
  • A change in the texture of the hair
  • Oily skin
  • Dry skin

We’d recommend doing a small patch test to see whether you’re sensitive to the ingredients. Just apply a little to the inside of your arm. If there are no issues after twenty-four hours, then it should be safe to use. 

If the side effects are bothering you, or if you start to lose hair, you need to see your doctor for an alternative. 

What Safety Information Should I Know?

Ketoconazole is an Azole antifungal. If you’re allergic, this product should be avoided. Speak to your doctor or pharmacist for alternatives and to discuss any other allergies you might experience. When buying the shampoo, check the list of ingredients for any other possible allergens.  

If you have serious health issues or take medication daily, it’s best to check with your health care provider or pharmacist about possible interactions with other drugs. If you’re not sure, we’d recommend speaking to your doctor and explaining what other meds you’re on. 

This shampoo can be used during pregnancy if needed, but only under the supervision of a physician. If the case is mild, it is better to investigate other potential remedies first. It is not clear whether it can be passed on through breast milk, so breastfeeding moms should avoid it. 


If you or anyone you know happens to swallow any of the liquid, treat it as an emergency. Get to the Emergency Room or call 911 as quickly as possible if the user becomes unconscious or is struggling to breathe. If the symptoms are not severe, call your local control center instead. 

Other Potential Effects

If the shampoo is being used to treat a skin condition, it may clear up the fungus without returning your skin to its natural color right away. It could take a few months to return to normal again.

If you want to put in a permanent wave, or any other kind of hair treatment, wait until the scalp condition has cleared. This treatment could affect the permanency of different hair treatments.

What Happens if I Miss a Dose? 

This medication is most effective when used consistently, as instructed. If you do miss a dose, your next order of action will depend on how close your next treatment is. If it is quite a while off, then treat yourself as soon as possible.

If it is quite near your next dose, skip the missed one entirely because it’s not a good idea to double up under any circumstances.


We’d recommend checking the manufacturer’s instructions about how best to store the product. The same rules apply as would most meds. Store away from direct light and in a cool environment. It’s best to keep it out of the bathroom. 

If you are finished with the product, or if you’ve found some expired in the cupboard, speak to your pharmacist about the best way to get rid of it. You shouldn’t just pour it down the sink or throw the bottle away.

Final Notes 

If you have a troublesome skin infection, this shampoo might be the right treatment for you. We do advise ensuring that there will be no interactions with any medication that you’re already taking. Aside from that, the allergy patch test should be more than ample protection.

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The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.